Application for Employment

 
Date of Application:
Position(s) Applied for:
Driver Light Industrial Administration    
 
Shifts available:
Permanent Temporary Part-Time Summer  
Days  Evenings Nights   Weekends  
Name:
Last First Middle
 
Address:
Street City Province
Postal Code Phone    
Emergency Contact Emergency Phone     
 
Address for the past 3 years:
Street City Postal Code How long?
Street City Postal Code How long?
 
Languages:
Written Fluently : English French Other
Spoken Fluently : English French Other
 
Have you ever worked for or sought employment with this company or any other Irving Company before?
Yes No

   

 

  

     
If yes, where
Are you now employed? 

If not, how long since leaving last employment?

Who referred you?

Rate of Pay expected 

Date available for work:  
Are you eligible to accept employment in Canada?  Yes No
Please list any relatives or friends working for this company or any other Irving companies (Identify with Company)
Do you have any physical disability or other condition which may limit your ability to perform the job applied for?
Yes No

If yes, please explain.

Have you ever been convicted of a criminal offense for which a pardon has not been granted?  Yes No
Have you ever had a fidelity bond denied, suspended or revoked?   
Yes No

If yes, please explain.

Are you willing to work continuous operation schedule (12 hour shifts and weekend work) as required?   Yes   No

Are you willing to work overtime as required?   Yes  No

Education    
School Name of School Address Grade or Degree
High School
College or University
Business or Technical
Computer Skills/ Typing speed:  
 
Additional Information
Are there any other experiences, skills or qualifications which you feel would qualify you for work with the company, such as any company/unit committees, social or otherwise? (Do you list any activities denoting age, ancestry, colour, or ethnic background, creed, language, martial or civil status, nationality, national or social origin/condition, physical or mental disabilities/handicap, place of origin, political opinion, race, religion, sex or sexual orientation.)
 
Employment History May we contact your present employer?  Yes  No
(Note: List employers in reverse order starting with the most recent. Add another sheet if necessary.)
Most Recent/ Current Employer
 
Name Date from (mo.) (yr.)  
Address Date to (mo.)  (yr.) 
City   Position Held
Prov. Salary/Wage 
Postal Code Reason for leaving
Supervisor & Title        
Phone Number        
 
Name Date from (mo.) (yr.)  
Address Date to (mo.)  (yr.) 
City   Position Held
Prov. Salary/Wage 
Postal Code Reason for leaving
Supervisor & Title        
Phone Number        
 
Name Date from (mo.) (yr.)  
Address Date to (mo.)  (yr.) 
City   Position Held
Prov. Salary/Wage 
Postal Code Reason for leaving
Supervisor & Title        
Phone Number        
 
Name Date from (mo.) (yr.)  
Address Date to (mo.)  (yr.) 
City   Position Held
Prov. Salary/Wage 
Postal Code Reason for leaving
Supervisor & Title        
Phone Number        
 
 
TO BE READ AND SIGNED BY APPLICANT

Protrans Personnel Services Inc. is committed to providing a healthy and safe working environment free from the negative effects of alcohol and drug use. The company has an alcohol and drug policy to support this commitment to health and safety. This policy requires participation in an alcohol and drug testing program, including a pre-employment drug test.

I hereby authorize the Company to verify the information contained in this Application for Employment. I further agree that any willful omission or misrepresentation shall be considered sufficient cause for denial or termination of employment. It is also agreed and understood that I will furnish such additional information and complete such examinations as may be required to complete my employment file.

I understand and agree that this application for employment in no way obligates the company to employ me. I understand that if I am hired, my employment will be subject to a 90 day probationary period during which time I may be discharged without notice or recourse.

If employed: (1)the applicant acknowledges he will be under the direct control of the customer and that the duration of his continual employment will depend entirely on the needs of the customer; (2) should the customer for any reason, dispense with the services of the applicant, the employer will endeavor to find other employment. However, the applicant agrees, that the employer's responsibility is limited to payment of salary for work actually performed and nothing more and have no recourse against the employer; (3) I will not accept permanent employment from any customer for whom I have worked until 3 months have elapsed after my last assignment; (4) I understand that I am required to abide by all rules and regulations of the company.

I, the undersigned, grant permission to the Irving group of companies to collect personal information about me (including test results of any kind) and to conduct reference and credit checks and a criminal record search for criminal convictions for which a pardon has not been granted. This information may be used to evaluate my application for employment and, if I am hired, this information may be kept in my employment file and updated from time to time. I agree that this information may be shared among the Irving group of companies. This permission includes my consent to the collection, use and communication of personal information under the Personal Information, Protection and Electronic Document Act, if applicable, and any similar provincial legislation.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Date                                                            Applicant's Signature

 
(For applicants applying for Light Industrial or Administrative work, your application is complete; for applicants applying for a driving position, please continue)
 

Experience and Qualifications - Other

 
Describe any trucking, transportation or other experience that may help in your work for this company
List courses and training other than those shown elsewhere in this application
List any special equipment or technical materials you can work with (other than those already shown)
 
Driving Experience      
Class of Equipment Type of Equipment
(Van,  Reefer, Tank, Flat, Etc...)		 From Date To Date Approx. Number of Miles
Straight Truck
Tractor & Semi Trailer
Tractor - Two Trailers
Bus
Other
Experience and Qualifications - Driver
Driver License Province License No. Type Expiration Date
 
 
A. Have you ever been denied a license, permit or privilege to operate a motor vehicle? Yes No
B. Has any license, permit or privilege to operate motor vehicle ever been suspended or revoked? Yes No
IF THE ANSWER TO EITHER A OR B IS YES, PLEASE GIVE DETAILS
Have you ever completed a driving course?Yes No    
If yes, which school, and when. 
Please list geographic area you have operated in for the past 5 years.
Accident Record FOR PAST 5 YEARS (include all preventable, non-preventable, and minor  accidents which you were involved in as a driver - attach an additional sheet if more space is needed)
 
Date Nature of accident (Head-on, rear-end,upset, etc...) Fatalities    Injuries
Traffic Convictions and Forfeitures for the past five years (other than parking)
Location Date Charge Penalty

 

IMPORTANT - Regulations require that we obtain a Driver's Abstract. Be sure to attach one